Between work, commutes, kids, partners with opposite schedules, and everything else you can think of, getting to a therapy office every week can be hard to fit into your schedule. For a lot of people, the logistics are what stop them from starting therapy, or keep them from sticking with it.
Online therapy makes that easier. You join from home, your car, or a private office. It’s a little different from being in the room, but for a lot of people it’s what makes therapy possible.
Does online therapy actually work?
For a lot of people, yes. When researchers compare therapy by video with therapy in person, people tend to improve in both. A review of trials on depression found the results roughly comparable and suggested video therapy can be a good alternative to coming into an office. It isn't the right fit for everyone, but for a lot of people it works well.
A common worry is that it'll feel distant or harder to open up. The first session or two can feel a bit different. But when researchers looked at how well clients and therapists worked together, they found no meaningful gap between online and in-person sessions, whether clients or therapists were the ones rating it. This is important due to the therapeutic alliance being one of the strongest and most consistent predictors of how therapy goes. In my experience, most people get used to it quickly, including clients who started in person and later moved online. I’ve had clients tell me they were worried online sessions wouldn’t feel the same. When that comes up, I always let them know they’re welcome to come in person. Sometimes I’ll suggest starting with a couple of in-person sessions, or coming in every so often, if that’s possible for them.
Can couples therapy work online?
Yes! For many couples, online sessions are what make regular therapy doable. It's hard to line up two schedules plus travel time. It's sometimes easier to find an hour when you're both home.
There's less research on couples than on individual therapy, but what’s been studied is positive. In a study comparing couples therapy virtually versus in person, couples in both groups improved in relationship satisfaction and saw drops in stress and anxiety, with no significant difference between formats. A separate study interviewed couples about their experience doing therapy by video. Some participants had doubts at the beggining, but most ended up comfortable with it, and some said video helped them stay focused on the conversation.
How online couples sessions usually work:
Same room, one screen. Most couples join together from home, sitting side by side so I can see you both. This is what I recommend when it’s possible.
Separate locations are okay too. If one of you is working late or you’re on different schedules, you can each join from your own device.
Structure when it helps. I usually start by asking how things have been since we last met. Anything big happen? Any arguments, any wins? From there, we decide together whether to follow a plan for the session, like working on how you handle conflict, or talk through whatever came up. Both work over video!
Home has its own advantage. You're practising new skills in the same place you'll use them.
Premarital counselling can also be done online.
What an online session actually looks like
Before your appointment, you’ll get a secure video link by email from Jane, the PHIPA-compliant platform I use for scheduling and client information. At your appointment time, just click the link and we’ll start from there. Everything you share is held to the same confidentiality standards as in-person therapy. A few practical tips:
Find a private spot - Anywhere private works: your living room if no one else is around, a room at home or work with the door closed, or even your parked(!!!) car. Headphones can help things feel more private if there are others at home!
Use a laptop or tablet if you can - A phone works, but a bigger screen makes it easier. I often screen share resources when in session and these can be hard to see on a phone screen!
Treat it like an appointment - Turn off notifications and close other tabs. It can be pretty easy to get distracted when the world is at your fingertips!
Is online therapy right for you?
Online therapy may suit you if you:
Have a packed or unpredictable schedule
Are a couple juggling work schedules, childcare, or a long commute
Feel more at ease talking from your own space
In-person might suit you better if you don't have a private place to talk at home, or if you focus better outside your home.
You also don't have to pick one forever. Some of my clients switch between online and in-person sessions depending on their schedule that week.
Booking a session
I offer online individual and couples therapy across Ontario, and in-person sessions in Hamilton. If you're not sure which option fits, you can book a free 15-minute consultation to talk it over.